Aim.This study was conducted to evaluate the caries resistance of hard tooh tissues and the state of the calcium and phosphorus  metabolism in children with type 1 diabetes mellitus given the  mineralizing potential of saliva and antimicrobial protection of the oral cavity.Materials and methods. There was conducted a general clinical, dental, laboratory examination of 127 children with type 1 diabetes  mellitus aged 7 to 12 years with the endocrinopathy experience from eight months to ten years. The obtained data were compared with  the results of the examination of 37 "healthy" and "practically  healthy" children of this age category. When assessing the dental  status of children, were used the hygienic index (Y.A. Fedorov, V.V.  Volodkina, 1970), the CFE/ cf index (WHO Expert Committee, 1962), the simplified hygienic index OHI-S (Green, Vermillion, 1964). The  intensity of the enamel demineralization processes was assessed  using the enamel resistance test (V.R. Okushko, L.I. Kosavera, 1984)  and vital staining (L.A. Aksamit, 1978). The electrometry of  hard tooth tissues was carried out by the electrodiagnostic apparatus "Dent Est" (V.K. Leontiev, G.G. Ivanova, 1985).The  laboratory diagnostics of the salivary indicators included the study of calcium (total, ionized), inorganic phosphorus, alkaline  phosphatase, osteocalcin, parathyroid hormone, 25-hydroxyvitamin D3, lactoferrin. The microcrystallization and  mineralizing potential of saliva were determined according to Leus  P.A. (1997).Results.At the early stages of type 1 diabetes mellitus development children have a compensated and subcompensated form of the  carious process, the increase in the enamel permeability, a slight  predominance of the demineralization processes over the  remineralization processes in solid tooth tissues. It indicates that  self-regulation of the mineral metabolism mechanisms takes place  while maintaining the physiological remineralizing properties of  saliva. At a late stage of type 1 diabetes mellitus development a high intensity and decompensated form of the carious lesions are  established as well as low structural and functional enamel  resistance and pronounced processes of hard tooth tissues  demineralization. The emergence of this complex in children with the experience of endocrinopathy for more than five years indicates the depletion of salivary gland functionality, the disturbance of  mobilization salivary systems in response to the occurrence of the  cariogenic situation in the oral cavity, the change in calcium  homeostasis, the decrease in enamel resistance to organic acids and the absence of saliva crystallization.Conclusion.The growing positive dynamics of index growth in children with long-term type 1 diabetes mellitus, indicating the  deterioration of the dental status, requires adherence to the  principles of rational nutrition, quarterly professional caries preventive measures using modern and effective oral care  products, the introduction of active forms of hygienic training and education taking into account the mineralizing potential of saliva as well as careful monitoring of the acquired manual skills.

This review presents the data devoted to anatomical and functional diversity of fibroblasts, peculiarities of metabolic processes and energy exchange in these cells. In particular, the changes in fibroblast proliferative activity depending on various factors are discussed. The review shows the influence of the malate dehydrogenase shuttle system on the activity of metabolic processes and the life span of fibroblastsin vitro. The increase of cell cultivation timein vitrois associated with the cytosolic isoform of this enzyme. The stability of fibroblast cell culture to the activation of free-radical processes and peroxidation with addition of biologically active compounds is described and followed by a discussion of the role of separate metabolites in providing free-radical protection and maintenance of the proliferative potential of cells.

Aim. This study was conducted to develop the optimal methodological approaches to early diagnosis and comprehensive treatment of type 1 diabetes mellitus in children by creating an estimation algorithm of the bone system metabolism based on the results of the studies of calcium phosphorus metabolism, calcium-regulating hormones and bone mineral density.Materials and methods. There was carried out a general clinical, laboratory, X-ray examination of 114 children with type 1 diabetes mellitus aged 7 to 12 years with an endocrinopathy experience from eight months to ten years. The obtained data were compared with the results of the examination of 35 “healthy” and “practically healthy” children of this age group. The densitometric measurement of the bone tissue mineral density in the lumbar spine was performed by the densitometer "Lunar iDXA" with the automatic calculation of the Z-test. Orthopantomography of the jaw bones was carried out by a digital orthopantomograph "ORTHOPHOS XG 3 DS" with the subsequent calculation of the Fuchs index and the X-ray index. Laboratory diagnosis of serum indicators included calcium study (total, ionized), inorganic phosphorus, alkaline phosphatase, calcitonin, osteocalcin, parathormone, 25- Hydroxyvitamin D. Indices of the bone resorption were evaluated by the level of a product of degradation of helical protein collagen type I C-terminal telopeptides (CTx, Beta-Cross laps) in blood serum.Results. At the early stages of development of type 1 diabetes mellitus the speed of bone tissue remodeling increases with increased bone formation. At the late stages of development of endocrine pathology the processes of bone remodeling are slowed down with the predominance of bone resorption processes over bone formation processes as well as a significant decrease in bone mineral density (Z-score <-1SD) with the predominance of criteria "within the expected age norms" and "low mineral density in relation to the average age norm" in the bone tissue structure. A statistically significant decrease in bone mineral density in children with a history of type 1 diabetes mellitus for more than five years is indicative of absolute insulin deficiency of pancreatic β cells as well as an early debut of endocrinopathy during the growth and development of bone tissue, triggering the formation of osteopenic syndrome.Conclusion. The introduction of the algorithm for evaluating bone tissue metabolism based on modern high-tech laboratory radiology methods for diagnosing the state of musculoskeletal system in practical public health will make it possible to identify the pathological changes at early stages, when the implementation of integrated therapeutic and prophylactic measures will have the greatest impact and improve the quality of life of children suffering from type 1 diabetes mellitus.